Staff perspectives on paperwork in group homes for people with intellectual disability

Abstract

Background: Paperwork can transform organisational aims into action in group homes, but it can also be problematic for staff. The aim of this study was to explore frontline staff perspectives on paperwork in group homes for people with intellectual disability. Methods: Constructivist grounded theory methodology guided the study. Data were collected from 29 participants through semi-structured interviews, participant observations and journaling. Coding and sorting methods were used to analyse participants' perspectives. Results: Staff have nuanced paperwork perspectives. They described and evaluated paperwork in terms of its value and fit with resident-focused practice. They identified gaps in paperwork and reimagined its design and use. Conclusions: Frontline staffs' reflection suggests some paperwork hinders them from supporting residents well. This suggests organisations could consult better with staff to design paperwork that has a goodness of fit to their practice. Further research could explore how staff manage the limiting characteristics of paperwork.

How frontline staff manage paperwork in group homes for people with intellectual disability: Implications for practice

“…Paper tools are considered important technologies for transforming organizational aims into daily practice (Levinson, ). The value that frontline staff place on paperwork as a means of facilitating staff communication and teamwork is similar to the way the early group home researchers perceived the benefits of paperwork (see Mansell, Felce, Jenkins, de Kock, & Toogood, ; Quilliam et al., , ). Over time, however, the use of paperwork has become increasingly prescriptive, possibly due to its contemporary role in managing service risks (Nankervis & Stancliffe, ; Quilliam et al., ).…”

“…From another perspective, staffs’ management of the rules can be positive, and understood as acts based on practice wisdom and critical reflection rather than acts of defiance (Fleming & Spicer, ; Garfinkel, ). Their practices allow them to use paperwork in the contextual moment, remaining focused on each resident's support needs and using paper tools suited to requirements of day‐to‐day support (Quilliam et al, ). Staffs’ managing practices illustrate their ability to transform ill‐fitting, organizationally focused paper tools into ones that better support their resident‐focused work.…”

“…They rely on verbal opportunities such as informal discussion between staff to share or gain information (Quilliam, ) and spend significant amounts of time doing paperwork using an increasing number of paper tools in their workplace (Mansell & Beadle‐Brown, ; Quilliam, Bigby, & Douglas, ). The term paper tool refers to paper‐based or electronic pieces of paperwork in group homes, and paperwork refers to the process of using these tools (Quilliam, Bigby, & Douglas, ).…”

“…Frontline staff experiences are important to understand because they are responsible for transforming organizational procedure into practice. The few studies that explore staffs’ paperwork experiences ask questions about the suitability of particular paper tools to support residents in daily practice and the implications of following prescribed procedures (Davis et al., ), or the characteristics of paper tools that hinder or help staff to support residents well (Quilliam et al, ). Asking these types of questions allows researchers to adopt different epistemological positions and explore staffs’ paperwork practices more broadly, rather than simply viewing them as correct or incorrect.…”

“…Recent research using a constructivist epistemological position exploring staffs’ perspective of paperwork found they drew on their practice wisdom about specific workplace and group home practices generally and critically evaluated the value of paper tools, limitations and overall goodness of fit for their work of supporting residents (Quilliam et al, ). In this study, staff considered paperwork particularly limiting when it required them to capture information that was irrelevant to practice, when it made them feel uncomfortable, or when it took too long to complete.…”